沙　丹　林文涛湖北省仙桃市第一人民医院检验科，湖北仙桃　433000

尿激酶溶栓治疗对急性脑梗死出血患者血清基质金属蛋白酶-9水平的影响

沙丹林文涛
湖北省仙桃市第一人民医院检验科，湖北仙桃433000

目的 探讨尿激酶溶栓治疗对急性脑梗死出血患者血清基质金属蛋白酶-9（MMP-9）水平的变化及其临床疗效。方法 选择2012年10月～2015年10月在我院诊治的急性脑梗死出血患者80例，根据随机数字表法分为治疗组与对照组各40例。常规基础治疗基础上，对照组应用重组组织型纤溶酶原激活剂溶栓治疗，治疗组应用尿激酶溶栓治疗，观察两组患者神经功能缺损、临床疗效、并发症及血清MMP-9水平的变化，治疗观察时间为7 d。结果 治疗后治疗组与对照组NIHSS评分分别为（6.35±1.33）分和（9.18±1.83）分，明显低于治疗前的（14.25± 1.55）分和（14.28±1.86）分（P＜0.05），同时组间比较差异有统计学意义（P＜0.05）。经过治疗，对照组和治疗组的有效率分别为82.5%、95.0%。治疗组治疗期间的再出血、颅内感染、迟发脑积水等并发症发生情况明显少于对照组（P＜0.05）。治疗后治疗组与对照组血清MMP-9含量分别为（82.33±12.83）ng/mL和（182.33±11.44）ng/mL，明显低于治疗前的（534.25±16.12）ng/mL和（531.28±21.23）ng/mL（P＜0.05），同时组间比较差异有统计学意义（P＜0.05）。结论尿激酶溶栓治疗能缓解急性脑梗死出血患者神经功能障碍，降低并发症的发生，从而提高治疗疗效，其作用的发挥可能与有效促进血清MMP-9含量降低有关。

尿激酶；溶栓治疗；急性脑梗死；脑出血；基质金属蛋白酶-9

［Abstract］Objective To investigate the changes of serum matrix metalloproteinase-9（MMP-9）levels and the clinical effects analysis of urokinase thrombolytic therapy in patients with acute cerebral infarction and hemorrhage.Methods 80 patients with acute cerebral infarction and hemorrhage in our hospital from October 2012 to October 2015 were divided into the treatment group and the control group according to the random number table method，40 cases in each group.On the basis of the conventional treatment，the control group was treated with the recombinant tissue plasminogen activator thrombolysis，and the treatment group was given the urokinase thrombolytic therapy.The neurological function，clinical efficacy，complications and changes of serum MMP-9 levels were observed.Treatment lasted for 7d. Results After treatment，the NIHSS scores in the treatment group and the control group were（6.35±1.33）points and （9.18±1.83）points that were significantly lower than before treatment of（14.25±1.55）points and（14.28±1.86）points（P＜0.05），there were statistically significant differences between the two groups（P＜0.05）.After the treatment，the response rates in the treatment group and the control group were 95.0%and 82.5%，respectively that the treatment group were significantly higher efficiency（P＜0.05）.The rebleeding，intracranial infection，delayed hydrocephalus and other complications in the treatment group during treatment were significantly less than the control group（P＜0.05）.After treatment，the serum MMP-9 contents in the treatment group and the control group were（82.33±12.83）ng/mL and（182.33±11.44）ng/mL that were significantly lower than before treatment of（534.25±16.12）ng/mL and（531.28±21.23）ng/mL（P＜0.05），there were statistically significant differences between the two groups（P＜0.05）.Conclusion The treatment of urokinase thrombolytic therapy of acute cerebral infarction and hemorrhage can ease neurological dysfunction，reduce the incidence of complications，thereby improve treatment efficacy，its role may be related to the effective decrease the serum MMP-9 levels.

［Key words］Urokinase；Thrombolytic therapy；Acute cerebral infarction；Cerebral hemorrhage；Matrix metalloproteinase-9

目前脑血管病在我国已超过恶性肿瘤，是致死率最高的一种疾病，减小脑血管患者的残疾率和死亡率是现阶段医学界急需解决的一大问题。……